Individual
JORDAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
629 S PLUMMER AVE, CHANUTE, KS 66720-1928
(620) 431-4000
Mailing address
1068 LYNX TER, BURLINGTON, KS 66839-9260
(620) 490-0470
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
T-06311
KS
Other
Enumeration date
05/26/2025
Last updated
05/26/2025
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